Investigating the relationship between visual impairment and cognitive impairment in the older adults using the novel vision screening assessment (VISA) tool

Background Early identification and multimodal treatment of dementia, especially Alzheimer's disease, is a common goal of global efforts. Objective This study aims to investigate the relationship between visual impairment (VI) and cognitive impairment in older adults using the Vision Screening Assessment (VISA) tool. Methods A total of 94 healthy older adults from community settings in Changzhou were recruited for the study. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Clock Drawing Test (CDT). The VISA tool was employed to evaluate participants’ visual acuity, ocular motility, visual fields, and visual attention. Results This study examined 94 participants, identifying 80 with VI, 26 with abnormal visual attention, 58 with cognitive impairment, and 11 with visuospatial dysfunction. Analyses showed: (1) Visual acuity negatively correlated with MMSE and CDT scores; (2) Groups with near vision impairment or visual attention abnormalities had significantly lower MMSE and CDT scores, while cognitively normal participants showed better visual acuity; (3) Logistic regression revealed MMSE scores were primarily influenced by left-eye near vision and visual attention, whereas CDT scores were additionally affected by education level; (4) Mediation analysis indicated left-eye near vision and visual attention may impact cognitive function via visuospatial function. Conclusions VI is closely associated with cognitive impairment, with left-eye near vision and visual attention potentially affecting cognition through their impact on visuospatial function. The application of the VISA tool may provide scientific evidence for optimizing dementia prevention and control strategies in China.